Juckett, Robert Shedd
Juckett, Robert Shedd is an individual health care provider with primary practice located at 133 S Northwest Hwy , Park Ridge IL 60068-4228. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Juckett, Robert Shedd can be contacted via phone (847) 384-2020.Contact Information
Primary practice address
133 S Northwest Hwy
Park Ridge IL 60068-4228
Phone: (847) 384-2020
Fax: (847) 823-2020
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | Illinois |
Profile Details
| NPI number | 1285792168 |
|---|---|
| LBN Legal business name | Juckett, Robert Shedd |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 4th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285792168 | NPPES |
| Illinois | Other | 168454 | BLUE CROSS BLUE SHIELD IL |
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